Evaluation of Systolic Function Flashcards

Week 6

1
Q

This is what the ventricles have in them prior to the atria emptying into the ventricles.

A

Preload

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2
Q

According to ____, increasing initial muscle length will result in no change or a reduction in the force of contraction.

A

Frank-Starling law

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3
Q

As preload ____ the LV fibers will lengthen in diastole and the force of systolic contraction will ____.

A

Increases; increases

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4
Q

____ is commonly estimated as EDP (or end-diastolic pressure or volume).

A

Preload

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5
Q

The ability of the heart to contract is affected by:

A

Afterload and Contractility (inotropic)

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6
Q

The force ventricles face when contracting in systole

A

Afterload

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7
Q

Afterload is ____ related to ventricular systolic pressure, ventricular radius, and is ____ related to ventricular thickness

A

Directly; inversely

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8
Q

An increase in afterload will result in a reduced ventricular force and velocity of contraction, leading to an ____ in end systolic volume. Causing the ventricle to thicken

A

Increase

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9
Q

The force or energy expended on the heart muscle resulting in contraction.

A

Contractility (inotropic)

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10
Q

Dobutamine is an example of a positive ____ agent.

A

Inotropic

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11
Q

____ ____ (chronotropic) is expressed as beats per minute (BPM).

A

Heart rate

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12
Q

A heart rate of < 60 BPM is considered ____.

A

Bradycardia

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13
Q

A heart rate of > 100 BPM is considered ____.

A

Tachycardia

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14
Q

Increase HR = ____ CO

A

Increase

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15
Q

What is the formula for CO?

A

CO = Stroke volume (SV) x HR

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16
Q

Intrinsic contractility is the intensity of its active state, or how much ____ is available and actin-myosin interactions.

17
Q

With higher heart rate, calcium levels may be higher within the muscle cells, and therefore the force of contraction will ____.

18
Q

How to we quantitatively measure RV systolic function?

A
  • Measure a length and width of the RV when enlarged
  • RV TDI (Measure the S’)
19
Q

When measuring RV TDI, S’ > ____ cm/s represents normal RV function

20
Q

For a Quantitative assessment of the LV use:

A
  • M-mode at the mid-papillary level
  • Teichholtz
  • Simpsons
  • Doppler if MR is present (dP/dt)
21
Q

____ measures of the rate of rise of ventricular pressure during IVCT.

22
Q

dP/dT is calculated by dividing the change in ____ by the change in ____.

A

Pressure; time

23
Q

If left ventricular systolic function is normal, dP/dt would be > ____.

A

1200 or .27 msec.

24
Q

If left ventricular systolic function is mild-moderately dysfunctional, dP/dt would be ____.

25
If left ventricular systolic function is severly dysfunctional, dP/dt would be < ____.
< 800 or > 32 msec
26
If a patient has a WMA (wall motion abnormality) then the ____ cannot be accurately calculated.
LV
27
____ ____ are when muscle segments are not moving BUT it has nothing to do with disease of the coronary artery.
Nonischemic WMA’s
28
Nonischemic WMA’s are usually noted when there is a ____ present.
LBBB (left bundle branch block)
29
An ____ alters the sequence of activation and the sequence of contraction of the LV.
LBBB (left bundle branch block)
30
Following machine settings can optimize endocardial definition:
- transducer frequency - gain - gray-scale settings - focus - harmonics - contrast (if necessary)
31
____ can detect inducible ischemia at earlier stages than visual estimates can.
Strain rate imaging
32
Strain rate imaging can determine different ____ viability states.
Myocardial
33
What is the strain protocol?
- PLAX - PSAX – LV - Apical 4 - Apical 2 - Apical 3 - Aortic valve CW with valve click - PW of MVI - Color to assess for MR
34
What are the two ways to assess strain?
- Global Longitudinal Strain (GLS) - Regional Strain patterns
35
A normal Global Longitudinal Strain (GLS) is ____ - ____%
-15 - -20 %
36
A reduced Global Longitudinal Strain (GLS) is when peak strain is less than ____%
-15
37